Chronic pancreatitis

Chronic pancreatitis Compared to acute– Maybe painless, normal amylase and lipase, mononuclear infiltrate and fibrosis TIGARO– Toxin(ethanol, hypercalcemia, hyperlipidemia, acidosis, CRF), idiopathic, Genetic, autoimmune(Sjogren, IBD, PBC), Recurrent acute, Obstructive Etiology– alcohol, smoking, hereditary pancreatitis(before 20yrs old), ductal obstruction, tropical pancreatitis, systemic(cystic fibrosis, SLE), CFTR, SPINK1, PRSS1,  Presentation– pain(after meal 15~30mins), steatorrhea>protein deficiency, pancreatic diabetes(alpha and […]

Acute pancreatitis

Acute pancreatitis Etiology– Gallstone(<0.5cm), ethanol, hyperlipidemia, hypocalcemia, infection, drug, trauma, ERCP, vasculitis, ishemia, CFTR, PRSS1, SPINK1 Presentation– Epigastric pain. nausea, vomiting, knee-chest position relief pain, Cullen’s sign, Grey Turner’s sign Lab– Amylase(6~12hrs elevated, 3~5 days subsided), lipase(4~8hrs elevated, day 1 reach the peak, 8~14 days subsided), Trypsinogen activation peptide (TAP) KUB– Colon cut off sign(bowel […]